Case report:
Ultrasonographic examination of a 30 years female gravida 2, para 1 with
no history of diabetes mellitus and hypertension, confirmed a live
intrauterine fetus at 34-35 week of gestation on cephalic presentation
confirming a singleton pregnancy. The fetus had an estimated weight of
2506 grams. The main lobe of placenta was observed on the posterior wall
of the uterus. A separate placental tissue along the upper anterior wall
measuring was noted and suspected to be a succenturiate lobe measuring
12.2 cm X 8.1 cm X 2.3cm. The female had two previous obstetric scans;
one at 8+3 weeks of gestation reporting a fetus of crown rump length of
19.3 mm and second anomaly scan at 21+6 weeks of gestation reporting
normal findings.
At 37+2 weeks of gestation the female presented to the emergency
department in end stage of labor. On monitoring, persistent fetal
tachycardia was noted with fetal heart rate of 180-187 bpm. Considering
the previous suspicion of presence of succenturiate placenta, Emergency
Lower Segment Cesarean Section was done under sub arachnoid spinal
block. A 3.180 kg infant was delivered with Apgar score of 7/10 at 1
minute and 8/10 at 5 minutes. On examination of placenta, presence of a
bilobed placenta with an accessory lobe connected to the main lobe of
placenta by fetal blood vessels was confirmed.